Yan Shibing1,2, Liu Liangren1, Wei Qiang1, Liao Hong3, Song Turun1, Lei Junhao1, Yang Lu1, Yuan Zhengyong2,4, Jiang Yonghao5, Fu Guangqing6, Li Yunxiang7, Cao Dehong1. 1. Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan Province, China. 2. Department of Urology, Dujiangyan Medical Center/Affiliated Hospital of Chengdu University, Dujiangyan City, Sichuan Province, China. 3. Department of Urology, Sichuan Provincial Cancer Hospital/the Second Provincial Hospital of Sichuan Province, Chengdu, Sichuan Province, China. 4. Department of Urology, First Affiliated Hospital of Chongqing Medical University, Chongqing, Sichuan Province, China. 5. Department of Urology, Second People's Hospital of Yibin City, Yibin City, Sichuan Province, China. 6. Department of Urology, Fourth People's Hospital of Zigong City, Zigong City, Sichuan Province, China. 7. Department of Urology, Nanchong Central Hospital, Nanchong City, Sichuan Province, China.
Abstract
OBJECTIVE: To evaluate the prognostic impact of tumour size on survival outcomes in upper urinary tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). PATIENTS AND METHODS: Data on 795 patients treated with RNU for UTUC from seven centres were retrospectively analysed with focus on tumour size. Clinicopathological features and relevant prognostic factors were compared between patients with tumours ≤3.0 cm and those with tumours >3.0 cm in size. The primary endpoints were cancer-specific survival (CSS), disease recurrence-free survival (RFS) and overall survival (OS). RESULTS: At a median follow-up of 32 months, 313 (39.4%) patients died from UTUC, 321 (40.4%) developed cancer recurrence, and 359 (45.1%) died from all causes. Tumour size >3.0 cm was associated with unfavourable clinicopathlogical features. Kaplan-Meier analysis showed that tumour size was significantly correlated with worse CSS, RFS and OS (all P < 0.001). Multivariate analysis showed that tumour size was an independent predictor of CSS (hazard ratio [HR] 2.296; P < 0.001), RFS (HR 2.193; P < 0.001) and OS (HR 2.417; P < 0.001). CONCLUSIONS: Tumour size >3.0 cm was a significant predictor of CSS, RFS and OS after RNU for patients with UTUC. Further studies are warranted before tumour size is included in risk prediction tools.
OBJECTIVE: To evaluate the prognostic impact of tumour size on survival outcomes in upper urinary tract urothelial carcinoma (UTUC) treated with radical nephroureterectomy (RNU). PATIENTS AND METHODS: Data on 795 patients treated with RNU for UTUC from seven centres were retrospectively analysed with focus on tumour size. Clinicopathological features and relevant prognostic factors were compared between patients with tumours ≤3.0 cm and those with tumours >3.0 cm in size. The primary endpoints were cancer-specific survival (CSS), disease recurrence-free survival (RFS) and overall survival (OS). RESULTS: At a median follow-up of 32 months, 313 (39.4%) patients died from UTUC, 321 (40.4%) developed cancer recurrence, and 359 (45.1%) died from all causes. Tumour size >3.0 cm was associated with unfavourable clinicopathlogical features. Kaplan-Meier analysis showed that tumour size was significantly correlated with worse CSS, RFS and OS (all P < 0.001). Multivariate analysis showed that tumour size was an independent predictor of CSS (hazard ratio [HR] 2.296; P < 0.001), RFS (HR 2.193; P < 0.001) and OS (HR 2.417; P < 0.001). CONCLUSIONS:Tumour size >3.0 cm was a significant predictor of CSS, RFS and OS after RNU for patients with UTUC. Further studies are warranted before tumour size is included in risk prediction tools.